*New @JAMA_current* adding to hospitalized #covid19 outcomes literature

1/
-Among 5700 patients in NYC
2634 met study endpoint of "discharged" or "died"
Of those:
-14.2% were treated in the ICU
-21% died
-For the 12% that were put on ventilators, 88% died https://jamanetwork.com/journals/jama/fullarticle/2765184">https://jamanetwork.com/journals/...

2/
60% of the patients were male

Most common comorbidities were hypertension (57%), obesity (42%) and diabetes (34%)

At triage:
-Only 30% had a fever
-Only 27.8% required oxygen at that time
-Only 17% were noted as tachypnic
-43% had tachycardia (HR>100)

3/ At admission, labs that were notably abnormal:
-troponin
-CRP
-ESR
-LDH

Clinically, this all fits w/ what I have been seeing in Boston over the past few weeks as well in the emergency room.

4/ People& #39;s vitals are not always abnormal at presentation, but the history is what usually tips us off.

A mentor at @BrighamWomens once said that the diagnosis is in the history. Still often true here.

At our hospital, the labs in tweet 3 are part of a "covid19" order set.

5/ And in many of the patients that I saw, these came back abnormal as well, consistent w/ this study.

Looking at death by age/gender, older men doing the worst

The study also re-affirms the very poor outcomes for those who eventually do get placed on a ventilator

6/ Keep in mind that these were patients who actually met an end-point of discharged/died

There are still a number who are in the hospital out of the original 5700

A longer term study may change some of these numbers (for instance, may find vent mortality% is ultimately lower)